Same-day discharge for pediatric laparoscopic gastrostomy.

Creator(s)

Charlene Dekonenko, Children's Mercy HospitalFollow
Wendy Jo Svetanoff, Children's Mercy HospitalFollow
Obiyo O. Osuchukwu, Children's Mercy HospitalFollow
Amy L. Pierce, Children's Mercy HospitalFollow
Beth A. Orrick, Children's Mercy HospitalFollow
Kristen L. Sayers, Children's Mercy HospitalFollow
Rebecca M. Rentea, Children's Mercy HospitalFollow
Pablo Aguayo, Children's Mercy HospitalFollow
Jason D. Fraser, Children's Mercy HospitalFollow
David Juang, Children's Mercy HospitalFollow
Richard J. Hendrickson, Children's Mercy HospitalFollow
Charles L. Snyder, Children's Mercy HospitalFollow
Walter S. Andrews, Children's Mercy Hospital
Shawn D. St Peter, Children's Mercy HospitalFollow
Tolulope A. Oyetunji MD MPH, Children's Mercy HospitalFollow

Document Type

Article

Publication Date

1-2021

Identifier

DOI: 10.1016/j.jpedsurg.2020.09.044

Abstract

BACKGROUND: Laparoscopic gastrostomy is a common procedure in children. We developed a same-day discharge (SDD) protocol for laparoscopic button gastrostomy.

METHODS: We performed a prospective observational study of children undergoing laparoscopic button gastrostomy and were eligible for SDD from August 2017-September 2019. Patients were eligible if: 1) the family was comfortable with eliminating overnight admission and were suitable candidates for outpatient surgery (absence of major co-morbidities), 2) they were not undergoing additional procedures requiring admission, and 3) they received pre-operative education.

RESULTS: Sixty-two patients who underwent laparoscopic button gastrostomy were eligible for SDD. The median age was 2.1 years [IQR 0.9-4.1], and the median weight was 10.5 kg [IQR 7.6-15.5]. Forty-one (66%) were previously nasogastric fed. The median operative time was 22 min [IQR 16-29]. The median time to initiation of feeds was 4.4 h [IQR 3.4-5.5]. Fifty-one (82%) were discharged the same day with a median length of stay of 9 h [IQR 7-10]. Eleven were admitted, most commonly for further teaching. Eleven SDD patients were seen in the emergency room[IQR 3-12] post-operatively, primarily for mechanical complications.

CONCLUSION: Same-day discharge following laparoscopic gastrostomy is safe and feasible for select pediatric patients who undergo pre-operative education. The SDD pathway results in a low admission rate and relatively low ER visits.

TYPE OF STUDY: Prospective Observational Study.

LEVEL OF EVIDENCE: Level II.

Journal Title

Journal of pediatric surgery

Volume

56

Issue

1

First Page

26

Last Page

29

Keywords

Button gastrostomy; Laparoscopic gastrostomy; Same-day surgery

Recommended Citation

Dekonenko C, Svetanoff WJ, Osuchukwu OO, et al. Same-day discharge for pediatric laparoscopic gastrostomy. J Pediatr Surg. 2021;56(1):26-29. doi:10.1016/j.jpedsurg.2020.09.044